The Impact of Stress on Pathogenetic Mechanisms of Obesity (Systematic Review)

Abstract

Obesity is reaching the scale of a pandemic and is growing progressively every year. Taking into account the introduction of quarantine in many countries of the world associated with COVID-19, alarge number of patients are in a state of constant stress, hypodynamics, hypoxemia, which contributes to the prevalence of this nosology. Under such conditions, there is a need for a detailed analysis of the impact of stress and other factors on the pathogenetic links in the development of obesity, determines the relevance of our study and the need to find more effective preventive measures in the practice of family medicine.The objective: is to analyse the pathogenetic mechanisms of obesity under the influence of stress and other factors using systematic analysis of literature data.Materials and methods. A systematic review of literature sources in the field of obesity and its pathogenetic aspects was conducted by keywords: pathogenesis of obesity, overveight, stress, hypothalamic-pituitary-adrenal system, orexin, serotonin for the period 2015–2020. The search was carried out mainly in PubMed and Cochrane databases. The bibliosemantic method and the method of systematic analysis were used.Results. According to the results of searches in the PubMed and Cochrane databases, 58131 sources were found by keywords, from which 29 most relevant research goals were selected, including: 16 systematic reviews, 2 meta-analyzes, 3 multicenter data and 8 cohort studies. It is established that despite the diversity of pathogenetic aspects of obesity, adipose tissue is an endocrine-active organ that changes the functional state of many organs and systems, leads to metabolic and hormonal changes, led primarily by disbalance of the hypothalamic region, which is responsible for somatoform and hormonal disorders, and for the body’s protective reactions on exposition of many orexogenic factors.Conclusion. A crucial point in the practice of a family doctor, which will help to effectively prevent the development of obesity and its noninfectious and infectious complications, is to study all possible risk factors, their complex interaction at all levels of pathogenetic changes. Taking into account the influence of stress factors on the hypothalamic region, which is one of the key links in the pathogenesis of metabolic and somatoform changes, will help to find more effective approaches to the correction of overweight.